イナイ　ケイ   Inai Kei   稲井　慶    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Influence of pregnancy on cardiac function and hemodynamics in women with Ebstein's anomaly.
掲載誌名	正式名：Acta obstetricia et gynecologica Scandinavica 略　 称：Acta Obstet Gynecol Scand ISSNコード：00016349/16000412
掲載区分	国外
出版社	John Wiley & Sons, Inc.
巻・号・頁	97,pp.1025-1031
著者・共著者	KANOH Miki†, INAI Kei*, SHINOHARA Tokuko, SHIMADA Eriko, SHIMIZU Mikiko, TOMIMATSU Hirofumi, OGAWA Masaki, NAKANISHI Toshio
担当区分	責任著者
発行年月	2018/05
概要	INTRODUCTION:We examined the perinatal outcomes and right ventricular function before pregnancy, during pregnancy, and after delivery in women with Ebstein's anomaly. MATERIAL AND METHODS:We retrospectively investigated the clinical course and mode of delivery and monitored hemodynamic parameters throughout pregnancy in 17 women with Ebstein's anomaly who delivered at our institution during the period of 1995-2015. RESULTS:Eight women, including nine pregnancies, underwent elective cesarean section, and nine women, including 14 pregnancies, underwent vaginal delivery. Elective cesarean section was performed in cases with significant heart failure or arrhythmias and in the presence of more than two of the following: cardiothoracic ratio ≥60%, moderate or severe tricuspid valve regurgitation, tricuspid valve regurgitation pressure gradient ≥35 mmHg during pregnancy. The cardiothoracic ratio and tricuspid valve regurgitation pressure gradient significantly increased during pregnancy compared with prepregnancy values. The New York Heart Association classification deteriorated from class I to class II or III in five cases during pregnancy. CONCLUSIONS:Although pregnancy was relatively safe among women with Ebstein's anomaly, some women developed cyanosis, arrhythmia, and heart failure, leading to elective cesarean section. Monitoring clinical and hemodynamic changes throughout pregnancy is advised to minimize maternal cardiac risk and select the appropriate mode of delivery.
DOI	10.1111/aogs.13373
PMID	29768659